| Title |
The effect of insulin administration on c-peptide in critically ill patients with type 2 diabetes
|
|---|---|
| Published in |
Annals of Intensive Care, May 2017
|
| DOI | 10.1186/s13613-017-0274-5 |
| Pubmed ID | |
| Authors |
Marco Crisman, Luca Lucchetta, Nora Luethi, Luca Cioccari, Que Lam, Glenn M. Eastwood, Rinaldo Bellomo, Johan Mårtensson |
| Abstract |
In critically ill patients with permissive hyperglycemia, it is uncertain whether exogenous insulin administration suppresses or enhances c-peptide secretion (a marker of pancreatic beta-cell response). We aimed to explore this effect in patients with type 2 diabetes. We prospectively enrolled a cohort of 45 critically ill patients with type 2 diabetes managed according to a liberal glucose protocol (target blood glucose 10-14 mmol/l). We recorded the administration of insulin and oral hypoglycemic agents and measured plasma c-peptide as surrogate marker of endogenous insulin secretion on the first two consecutive days in ICU. Overall, 20 (44.4%) patients required insulin to achieve target blood glucose. Insulin-treated patients had higher glycated hemoglobin A1c, more premorbid insulin-requiring type 2 diabetes, and greater blood glucose levels but lower c-peptide levels on admission. Premorbid insulin-requiring diabetes was independently associated with lower admission c-peptide, whereas greater plasma creatinine was independently associated with higher levels. Increases in c-peptide were positively correlated with an increase in blood glucose both in patients who did (r = 0.54, P = 0.01) and did not (r = 0.56, P = 0.004) receive insulin. However, insulin administration was independently associated with a greater increase in c-peptide (P = 0.04). This association was not modified by the use of oral insulin secretagogues. C-peptide, a marker of beta-cell response, responds to and is influenced by glycemia and renal function in critically ill patients with type 2 diabetes. In addition, in our cohort, exogenous insulin administration was associated with a greater increase in c-peptide in response to hyperglycemia. Trial Registration Australian New Zealand Clinical Trials Registry (ACTRN12615000216516). |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| New Zealand | 1 | 3% |
| Unknown | 36 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 5 | 14% |
| Researcher | 4 | 11% |
| Student > Bachelor | 4 | 11% |
| Student > Postgraduate | 3 | 8% |
| Other | 2 | 5% |
| Other | 7 | 19% |
| Unknown | 12 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 27% |
| Nursing and Health Professions | 5 | 14% |
| Engineering | 4 | 11% |
| Biochemistry, Genetics and Molecular Biology | 2 | 5% |
| Chemistry | 1 | 3% |
| Other | 1 | 3% |
| Unknown | 14 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 June 2017.
All research outputs
#20,420,242
of 22,971,207 outputs
Outputs from Annals of Intensive Care
#963
of 1,050 outputs
Outputs of similar age
#270,050
of 310,149 outputs
Outputs of similar age from Annals of Intensive Care
#28
of 32 outputs
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